Physician specialist payments could vary as much as 29% by 2020 under the Merit-Based Incentive Payment System (MIPS), according to the October 5 press release by Avalere. This is due to CMS’s proposal to include Medicare payments for Part B drugs in the calculation of the MIPS payment adjustment.
A one-size-fits-all approach to case management and patient care can be detrimental to patients and the case management profession, but so too can designing a new approach to care plans for every patient who walks through the door, according to an article in CMSA Today.
The Centers for Disease Control and Prevention (CDC), one of the Cooperating Parties responsible for the ICD-10-CM codes and guidelines, recently released a 2018 ICD-10-CM Official Guidelines for Coding and Reporting errata. Slight changes were made to the guidelines for diabetes, hypertension, and principal diagnosis selection.
Five senators recently asked the Government Accountability Office (GAO) to examine the costs and risks associated with mismatched patient records during the agency’s review of patient matching. The GAO is required by the 21st Century Cures Act to conduct an assessment on patient matching to protect patient privacy and security.
Q: We are using a biosimilar for infliximab but it is manufactured by Merck/Samsung rather than Pfizer/Hospira. CMS requires that a manufacturer specific modifier be appended to the HCPCS code. Is there a new one for Merck/Samsung?
At a recent meeting, the Medicare Payment Advisory Commission (MedPAC) discussed an alternative policy to replace the Merit-based Incentive Payment System (MIPS) in order to reduce provider burden. MedPAC is an organization which advises CMS on Medicare policy issues.
